Hiding the Buck

by
Robert V. West, MD JD FAAEM

I recently read a glowing report regarding the Truth about
Contract Management Groups in another newsletter. The author (a recruiter)
was impressing upon her readers that the physicians she interviewed were
favorably impressed with the CMGs administrative support services
and their individual contract provisions, except one. How much?

The ultimate question however which was not addressed in the article
or in any CMG contract is how much are we paying for these services? The
convoluted nature of the medical staffing business is that we (the principles)
are generating the professional fees from which the CMGs (our agents)
are collecting their revenues and our fees without full disclosure. The
applicable contract provision usually reads, the physician agrees
to assign to the CMG all of the professional fees in exchange for $X per
hour. Neither the contract nor the CMG will ever intentionally tell
you the numbers that are omitted, your gross revenues plus their administrative
stipend from your hospital.

Hence the problem with this CMG analysis and the modus operandi for the
entire ED staffing industry is nondisclosure. Profits are garnered from
physicians fees based upon policies and procedures that we the physicians
dont have access to. Hence by keeping us in the dark, there is no
bargaining position available other than that one of take it or leave
it. If we dont know how much we are generating, there can never
be a fair and truthful analysis of any contract? As long as there are
closed books, there will be only partial truths told about CMGs. They
need to keep working in the dark for what they decide to pay.